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[Table of Contents]
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Volume: 23S2 • March 1997
AN INTEGRATED PROTOCOL TO MANAGE HEALTH CARE WORKERS EXPOSED
TO BLOODBORNE PATHOGENS
Recommendations for an Integrated Protocol
2. Evaluating a Significant Exposure
The type of body fluid and the type of injury must be investigated to determine
if the exposure of the HCW to a bloodborne pathogen is significant. A combination
of one of the types of body fluids and one of the injuries listed below constitutes
a significant exposure.
2.1 Types of body fluids
Body fluids capable of transmitting HBV, HCV, and HIV from an infected
individual include:
- blood, serum, plasma, and all biologic fluids visibly contaminated with
blood
- laboratory specimens, samples, or cultures that contain concentrated
HBV, HCV, and HIV
- organ and tissue transplants
- pleural, amniotic, pericardial, peritoneal, synovial, and cerebrospinal
fluids
- uterine/vaginal secretions or semen (unlikely to transmit HCV)
- saliva (for HBV only, unless contaminated with blood).
Feces, nasal secretions, sputum, tears, urine, and vomitus are not implicated
in the transmission of HBV, HCV, and HIV unless visibly contaminated with blood.
The risk of transmission from screened, donated blood, and manufactured blood
products is negligible in Canada.
2.2 Types of injuries
Injuries in which one of the infected fluids listed in 2.1 comes into contact
with the HCW's:
- tissue under the skin (e.g. percutaneous or following a bite when the
skin is broken)
- non-intact skin (e.g. cut, chapped or abraded skin +)
- mucous membrane (e.g. eyes, nose, or mouth).
In summary, further investigation is warranted if the type of body fluid
and the type of injury indicates that a significant exposure has occurred.
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+ The larger the area of skin exposed and the longer the time of contact, the
more important it is to verify that all the relevant skin area is intact.
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